Annals of Coloproctology

Volume 38(3); June 2022

Editorial

Malignant disease,Colorectal cancer

Tailoring strategies for colorectal cancer screening and treatment based on age in colorectal cancer patients: Eun Jung Park; Ann Coloproctol. 2022;38(3):181-182. Published online June 27, 2022; DOI: https://doi.org/10.3393/ac.2022.00395.0056

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Robotic versus laparoscopic surgery for colorectal cancer in older patients: a systematic review and meta-analysis
Xinyu Wang, Rui Ma, Tiewei Hou, Hao Xu, Cheng Zhang, Chun Ye
Minimally Invasive Therapy & Allied Technologies.2024; : 1. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef

Review

Benign proctology

A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence: Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son; Ann Coloproctol. 2022;38(3):183-196. Published online June 9, 2022; DOI: https://doi.org/10.3393/ac.2022.00276.0039

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The complexity in the molecular mechanism of the internal anal sphincter (IAS) limits preclinical or clinical outcomes of fecal incontinence (FI) treatment. So far, there are no systematic reviews of IAS translation and experimental studies that have been reported. This systematic review aims to provide a comprehensive understanding of IAS critical role in FI. Previous studies revealed the key pathway for basal tone and relaxation of IAS in different properties as follows; calcium, Rho-associated, coiled-coil containing serine/threonine kinase, aging-associated IAS dysfunction, oxidative stress, renin-angiotensin-aldosterone, cyclooxygenase, and inhibitory neurotransmitters. Previous studies have reported improved functional outcomes of cellular treatment for regeneration of dysfunctional IAS, using various stem cells, but did not demonstrate the interrelationship between those results and basal tone or relaxation-related molecular pathway of IAS. Furthermore, these results have lower specificity for IAS-incontinence due to the included external anal sphincter or nerve injury regardless of the cell type. An acellular approach using bioengineered IAS showed a physiologic response of basal tone and relaxation response similar to human IAS. However, in both cellular and acellular approaches, the lack of human IAS data still hampers clinical application. Therefore, the IAS regeneration presents more challenges and warrants more advances.

Citations

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Tissue engineering and regenerative medicine approaches in colorectal surgery
Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
Annals of Coloproctology.2024; 40(4): 336. CrossRef
Differentiation of Adipose-Derived Stem Cells into Smooth Muscle Cells in an Internal Anal Sphincter-Targeting Anal Incontinence Rat Model
Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, You-Rin Kim, Wook Chun, Jong Wan Kim, Il Tae Son
Journal of Clinical Medicine.2023; 12(4): 1632. CrossRef
Improving Efficiency and Accuracy in English Translation Learning: Investigating a Semantic Analysis Correction Algorithm
Lingmei Cao, Junru Fu
Applied Artificial Intelligence.2023;[Epub] CrossRef

Original Articles

Malignant disease,Colorectal cancer,Prognosis,Epidemiology & etiology

Clinicopathologic characteristics and survival of patients with double primary malignancies: breast and colorectal cancer: Hyundo Lee, Hae Won Lee, Eun Jung Park, Jeonghyun Kang, Seung Hyuk Baik; Ann Coloproctol. 2022;38(3):197-206. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00640.0091

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Abstract PDF Supplementary Material

Purpose
This study aimed to investigate the clinicopathologic features and survival in patients with both breast cancer (BrC) and colorectal cancer (CRC).
Methods
Between 1996 and 2019, patients who were diagnosed with both BrC and CRC were evaluated retrospectively. Patients with distant metastasis, palliative resection, and previous cancer histories except for BrCs or CRCs were excluded. Altogether, 105 patients were divided into the B=C group (n=21), B-first group (n=40), and C-first group (n=44) according to the definition of synchronous and metachronous cancers. The clinicopathologic features and overall survival were evaluated.
Results
TNM stages and histologic types were comparable among the 3 groups (P=0.434). The interval of diagnosis was 67.1±40.4 and 59.3±47.2 months in the B- and C-first groups, respectively. The incidence of adjuvant chemotherapy in the B-first group was 57.5%, which was higher than the B=C and C-first groups (P<0.001). The estrogen receptor, progesterone receptor, Ki-67, and HER-2 molecular markers were not significantly different among the groups. The overall survival of the B-first group showed lower survival rates than the C-first group (P=0.039). In the logistic regression, HER-2 status (hazard ratio [HR], 11.9; P=0.032) and lymph node metastasis of CRC (HR, 5.8; P=0.036) were prognostic factors affecting overall survival.
Conclusion
B-first group had poorer survival outcomes than the C-first group in patients with the metachronous BrC and CRC. HER2 positivity and CRC lymph node metastasis may be prognostic factors that affect overall survival in these patients. The findings support that a colorectal cancer screening program should be included during BrC surveillance.

Citations

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Synchronous or metachronous breast and colorectal cancers in younger-than-average-age patients: a case series
Jordyn Silverstein, Francis Wright, Dalila Stanfield, Amy Jo Chien, Jasmine M Wong, John W Park, Amie Blanco, Katherine Van Loon, Chloe E Atreya
The Oncologist.2024; 29(9): e1159. CrossRef
Synchronous Breast and Colorectal Malignant Tumors—A Systematic Review
Cristian Iorga, Cristina Raluca Iorga, Alexandru Grigorescu, Iustinian Bengulescu, Traian Constantin, Victor Strambu
Life.2024; 14(8): 1008. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Minimally invasive surgery

Should transanal total mesorectal excision be implemented in medium-sized colorectal unit? technical and oncological outcome: Man-fung Ho, Dennis Chung-Kei Ng, Janet Fung-yee Lee, Simon Siu-man Ng; Ann Coloproctol. 2022;38(3):207-215. Published online July 28, 2021; DOI: https://doi.org/10.3393/ac.2020.00941.0134

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Abstract PDF

Purpose
This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME.
Methods
Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile.
Results
Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P=0.029), but the operating time was longer (259 minutes vs. 219 minutes, P=0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P=0.670). At a median follow up of 39 months, no abnormal early recurrence was detected.
Conclusion
It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Citations

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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef

Malignant disease,Prognosis

Recurrence after endoscopic resection of small rectal neuroendocrine tumors: a retrospective cohort study: Sukit Pattarajierapan, Supakij Khomvilai; Ann Coloproctol. 2022;38(3):216-222. Published online July 20, 2021; DOI: https://doi.org/10.3393/ac.2021.00017.0002

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Abstract PDF

Purpose
According to the European Neuroendocrine Tumor Society consensus guidelines, rectal neuroendocrine tumors (NETs) up to 10 mm in size and without poor prognostic factors could be safely removed with endoscopic resection, suggesting omitting surveillance colonoscopy after complete resection. However, the benefit of surveillance colonoscopy is still unknown. In this study, we aimed to report the outcomes after endoscopic resection of small rectal NETs using our surveillance protocol.
Methods
This retrospective cohort study included patients who underwent endoscopic resection for rectal NETs sized up to 10 mm from January 2013 to December 2019 at our center. We excluded patients without surveillance colonoscopy and those lost to follow-up. We strictly performed surveillance colonoscopy 1 year after endoscopic resection, and every 2 to 3 years thereafter. The primary outcomes were tumor recurrence and occurrence of metachronous tumors during followup.
Results
Of the 54 patients who underwent endoscopic resection for rectal NETs during the study period, 46 were enrolled in this study. The complete resection rates by endoscopic mucosal resection, precutting endoscopic mucosal resection, and endoscopic submucosal dissection were 92.3% (12 of 13), 100% (21 of 21), and 100% (12 of 12), respectively. There was no local or distant recurrence during the median follow-up of 39 months. However, we found that 8.7% (4 of 46) of patients developed metachronous NETs. All metachronous lesions were treated with precutting endoscopic mucosal resection.
Conclusion
Surveillance colonoscopy is reasonable after endoscopic resection of small rectal NETs for timely detection and treatment of metachronous lesions. However, larger collaborative studies are needed to influence the guidelines.

Citations

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Comparison of the efficacy of endoscopic submucosal dissection and transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors ≤ 2 cm
Rui Jin, Xiaoyin Bai, Tianming Xu, Xi Wu, Qipu Wang, Jingnan Li
Frontiers in Endocrinology.2023;[Epub] CrossRef
Current status of the role of endoscopy in evaluation and management of gastrointestinal and pancreatic neuroendocrine tumors
Zaheer Nabi, Sundeep Lakhtakia, D. Nageshwar Reddy
Indian Journal of Gastroenterology.2023; 42(2): 158. CrossRef

Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery

Laparoscopy offers better clinical outcomes and long-term survival in patients with right colon cancer: experience from national cancer center: Muhammad Fahd Shah, Awais Naeem, Ihtisham ul Haq, Shehryar Riaz, Osama Shakeel, Sofoklis Panteleimonitis, Shahid Khattak, Aamir Ali Syed, Amjad Parvaiz; Ann Coloproctol. 2022;38(3):223-229. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2021.00045.0006

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Abstract PDF

Purpose
Laparoscopic approach to colonic tumor requires skill set and resources to be established as routine standard of care in most centers around the world. It presents particular challenge in country like Pakistan due to economic constrain and lack of teaching and training opportunities available for surgeons to be trained to deliver such service. The aim of this study is to look into changing practice of our institution from conventional approach of open to laparoscopic surgery for right colon cancer.
Methods
Consecutive patients between January 2010 to December 2018 who presented to Shaukat Khanum Memorial Cancer Hospital and Research Centre with diagnosis of right colon (cecum, ascending and transverse colon) adenocarcinoma and underwent surgical resections were included in this study.
Results
A total of 230 patients with adenocarcinoma of the right colon underwent curative resections during the study period. Of these, 141 patients (61.3%) underwent laparoscopic surgery while open resection was performed in 89 patients (38.7%). Five-year disease-free survival (DFS) of patients with American Joint Committee on Cancer (AJCC) stage III (80.9% vs. 54.8%, P = 0.021) was significantly better if these patients underwent laparoscopic surgery while a trend toward better DFS (96.7% vs. 84.1%, P = 0.111) was also observed in AJCC stage II patients, although this difference was not significant.
Conclusion
This study demonstrates the adoption of a laparoscopic approach for right colon cancer over 10 years. With a standardized approach and using the principle of oncological surgery, we incorporated this in our minimally invasive surgery practice at our institution.

Citations

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Short-Term Outcomes of First 100 Laparoscopic Colorectal Surgeries at a Newly Developed Surgical Setup at Peshawar
Muhammad F Shah, Irfan Ul Islam Nasir, Riaz Ahmad, Sajjad Ahmad, Aalia Amjad, Khush Bakht Zaineb, Romana Rehman
Cureus.2024;[Epub] CrossRef
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy
Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park
Journal of Minimally Invasive Surgery.2022; 25(3): 116. CrossRef
Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2021; 37(6): 434. CrossRef

Malignant disease, Rectal cancer, Functional outcomes

Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection: Amir Keshvari, Abolfazl Badripour, Mohammad Reza Keramati, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Ehsan Rahimpour, Parisa Ghaffari, Seyed Mohsen Ahmadi Tafti; Ann Coloproctol. 2022;38(3):230-234. Published online June 10, 2021; DOI: https://doi.org/10.3393/ac.2021.00059.0008

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Abstract PDF

Purpose
Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR.
Methods
All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up.
Results
Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up.
Conclusion
In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

Citations

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Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection
Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri, Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi, Zahra Sajjadian, Alireza Hadizadeh, Seyed-M
Updates in Surgery.2023; 75(4): 847. CrossRef
Endoscopic vacuum therapy and early surgical closure after pelvic anastomotic leak: meta-analysis of bowel continuity rates
F. Borja de Lacy, Kevin Talboom, Sapho X. Roodbeen, Robin Blok, Anna Curell, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
British Journal of Surgery.2022;[Epub] CrossRef
Outpatient closure in a late colo-cutaneous postoperative anastomotic leak managed with EVAC in Bucaramanga, Colombia. Case report.
Jairo Enrique Mendoza Saavedra, Cesar Andrés Torres Carrillo, Gloria Liliana Mendoza Valbuena
International Journal of Surgery Case Reports.2022; 100: 107737. CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer

Comparison of the oncological outcomes of stenting as a bridge to surgery and surgery alone in stages II to III obstructive colorectal cancer: a retrospective study: Hiroaki Uehara, Toshiyuki Yamazaki, Akira Iwaya, Hitoshi Kameyama, Masaru Komatsu, Motoharu Hirai; Ann Coloproctol. 2022;38(3):235-243. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.01067.0152

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Graphical Abstract Abstract PDF

Purpose
We evaluated the oncological outcomes of bridge to surgery (BTS) using stent compared with surgery alone for obstructive colorectal cancer.
Methods
Consecutive patients who underwent curative resection for stages II to III obstructive colorectal cancer at our institution from January 2009 to March 2020, were registered retrospectively and divided into 43 patients in the BTS group and 65 patients in the surgery alone group. We compared the surgical and oncological outcomes between the 2 groups.
Results
Stent-related perforation did not occur. One patient in whom the stent placement was unsuccessful underwent emergency surgery with poor decompression (clinical success rate, 97.7%). The pathological characteristics were not significantly different between the groups. The following surgical outcomes in the BTS group were superior to those in the surgery alone group; nonemergency surgery (P<0.001), surgical approach (P=0.006), and length of hospital stay (P=0.020). The median follow-up time was 44.9 months (range, 1.1–126.5 months). The 3-year relapse-free survival rates were 68.4% and 58.2% (P=0.411), and the overall survival rates were 78.3% and 88.2% (P=0.255) in the surgery alone and BTS groups, respectively. The 3-year locoregional recurrence rates were 10.2% and 8.0% (P=0.948), and distant metastatic recurrence rates were 13.3% and 30.4% (P=0.035) in the surgery alone and BTS groups, respectively.
Conclusion
This study revealed that BTS with stent may be associated with a higher frequency of distant metastatic recurrence. Stent for stages II to III obstructive colorectal cancer potentially worsens oncological outcomes.

Citations

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Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Oncologic impact of colonic stents for obstructive left-sided colon cancer
Hideyuki Suzuki, Shingo Tsujinaka, Yoshihiro Sato, Tomoya Miura, Chikashi Shibata
World Journal of Clinical Oncology.2023; 14(1): 1. CrossRef
5-year oncological outcomes in left-sided malignant colonic obstruction: stent as bridge to surgery
Noura S Alhassan, Sulaiman A AlShammari, Razan N AlRabah, Amirah M AlZahrani, Maha-Hamadien Abdulla, Thamer A Bin Traiki, Ahmad M Zubaidi, Omar A Al-Obeed, Khayal A Alkhayal
BMC Gastroenterology.2023;[Epub] CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef
Colonic stent for bridge to surgery for acute left-sided malignant colonic obstruction: A review of the literature after 2020
Margherita Binetti, Augusto Lauro, Valeria Tonini
World Journal of Clinical Oncology.2022; 13(12): 957. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

Characteristics and outcomes of colorectal cancer surgery by age in a tertiary center in Korea: a retrospective review: Tae-Hoon Lee, Jeong Min Choo, Jeong Sub Kim, Seon Hui Shin, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2022;38(3):244-252. Published online November 4, 2021; DOI: https://doi.org/10.3393/ac.2021.00619.0088

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Graphical Abstract Abstract PDF

Purpose
Colorectal cancer (CRC) occurs in all age groups, and the application of treatment may vary according to age. The study was designed to identify the characteristics of CRC by age.
Methods
A total of 4,326 patients undergoing primary resection for CRC from September 2006 to July 2019 were reviewed. Patient and tumor characteristics, operative and postoperative data, and oncologic outcome were compared
Results
Patients aged 60 to 69 years comprised the largest age group (29.7%), followed by those aged 50 to 59 and 70 to 79 (24.5% and 23.9%, respectively). Rectal cancer was common in all age groups, but right-sided colon cancer tended to be more frequent in older patients. In very elderly patients, there were significant numbers of emergency surgeries, and the frequencies of open surgery and permanent stoma were greater. In contrast, total abdominal colectomy or total proctocolectomy was performed frequently in patients in their teens and twenties. The elderly patients showed more advanced tumor stages and postoperative ileus. The incidence of adjuvant treatment was low in elderly patients, who also had shorter follow-up periods. Overall survival was reduced in older patients with stages 0 to 3 CRC (P<0.001), but disease-free survival did not differ by age (P=0.391).
Conclusion
CRC screening at an earlier age than is currently undertaken may be necessary in Korea. In addition, improved surgical and oncological outcomes can be achieved through active treatment of the growing number of elderly CRC patients.

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Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer?
Gyung Mo Son
Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Tailoring strategies for colorectal cancer screening and treatment based on age in colorectal cancer patients
Eun Jung Park
Annals of Coloproctology.2022; 38(3): 181. CrossRef
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef

Malignant disease, Rectal cancer,Prognosis,Biomarker & risk factor

Can pretreatment platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict long-term oncologic outcomes after preoperative chemoradiation followed by surgery for locally advanced rectal cancer?: Sang Hyun An, Ik Yong Kim; Ann Coloproctol. 2022;38(3):253-261. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00633.0090

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Abstract PDF

Purpose
Systemic inflammation is associated with various malignancies, including colorectal cancer, as possible prognostic predictors. We aimed to evaluate the correlation of pretreatment the platelet-to-lymphocyte (PLR) and the neutrophil-to-lymphocyte (NLR) ratio with long-term oncologic outcomes and pathologic complete response (pCR) in locally ad vanced rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy (CRT) followed by curative resection.
Methods
Between October 1996 and December 2015, 168 rectal cancer patients treated with preoperative CRT followed by surgery were enrolled. The set cut-off/mean PLR and NLR were 170 and 2.8. We analyzed the relationship between PLR, NLR, and the 5-year overall survival (OS), disease-free survival (DFS), and pCR rate.
Results
The 5-year OS rates were 75.9% and 59.8% in the highand low-PLR groups. The 5-year DFS rates were 62.9% and 50.8% in the high- and low-PLR groups, with no significant difference. In addition, the 5-year OS rates were 75.7% and 58.4%, and the 5-year DFS rates were 62.5% and 50.0% in the high- and low-NLR groups, respectively, both without any significant difference. Multivariate analysis showed only pretreatment PLR as an independent prognostic factor for OS (hazard ratio, 1.850; 95% confidence interval, 1.041–3.287; P=0.036), and both serologic markers were not independent prognostic factors for 5-year DFS.
Conclusion
Neither PLR nor NLR was associated with 5-year DFS nor pCR to neoadjuvant CRT. Only pretreatment PLR can be used in predicting OS in locally advanced rectal cancer patients who received neoadjuvant CRT followed by curative resection.

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Effect of preoperative pan-immune-inflammation value on clinical and oncologic outcomes after colorectal cancer surgery: a retrospective study
Yun Ju Seo, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek, Sung Uk Bae
Annals of Surgical Treatment and Research.2024; 106(3): 169. CrossRef
Systemic Inflammatory Response Following Preoperative Chemoradiotherapy Can Affect Oncologic Outcomes in MSI-H/dMMR Rectal Cancer
Hyukjin Choi, Jin Ho Baek, An Na Seo, Su Yeon Park, Hye Jin Kim, Jun Seok Park, Gyu Seog Choi, Jong Gwang Kim, Byung Woog Kang
Chonnam Medical Journal.2024; 60(2): 105. CrossRef
Predictive and prognostic value of inflammatory markers in locally advanced rectal cancer (PILLAR) – A multicentric analysis by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Study Group
Giuditta Chiloiro, Angela Romano, Silvia Mariani, Gabriella Macchia, Diana Giannarelli, Luciana Caravatta, Pierfrancesco Franco, Luca Boldrini, Alessandra Arcelli, Almalina Bacigalupo, Liliana Belgioia, Antonella Fontana, Elisa Meldolesi, Giampaolo Montes
Clinical and Translational Radiation Oncology.2023; 39: 100579. CrossRef
Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis
Giuseppe Portale, Patrizia Bartolotta, Danila Azzolina, Dario Gregori, Valentino Fiscon
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Neutrophil-to-lymphocyte ratio predicts survival of patients with rectal cancer receiving neo-adjuvant chemoradiation followed by radical resection: a meta-analysis
Giuseppe Colloca, Antonella Venturino, Domenico Guarneri
Expert Review of Anticancer Therapy.2023; 23(4): 421. CrossRef
Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
Chul Seung Lee
Annals of Coloproctology.2023; 39(4): 287. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Body composition parameters combined with blood biomarkers and magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Jianguo Yang, Qican Deng, Zhenzhou Chen, Yajun Chen, Zhongxue Fu
Frontiers in Oncology.2023;[Epub] CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef
Study on the Relationship between NEUT, NLR, PLR and the Severity of Coronary Artery Disease in Patients with ACS
延春蒋
Advances in Clinical Medicine.2022; 12(11): 9836. CrossRef

Benign GI diease,Benign diesease & IBD,Complication,Surgical technique

Efficacy and Safety of Endoscopic Clipping for Acute Anastomotic Bleeding After Colorectal Surgery: Ryun Kyong Ha, Kyung Su Han, Sung Sil Park, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Bun Kim; Ann Coloproctol. 2022;38(3):262-265. Published online October 26, 2021; DOI: https://doi.org/10.3393/ac.2021.00297.0042

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Abstract PDF

Purpose
Anastomotic bleeding after colorectal surgery is a rare, mostly self-limiting, postoperative complication that could lead to a life-threatening condition. Therefore, prompt management is required. This study aimed to evaluate the efficacy and safety of endoscopic clipping for acute anastomotic bleeding after colorectal surgery.
Methods
We retrospectively reviewed the data of patients pathologically diagnosed with colorectal cancer at National Cancer Center, Korea from January 2018 to November 2020, which presented with anastomotic bleeding within the first postoperative week and were endoscopically managed with clips.
Results
Nine patients had anastomotic bleeding, underwent endoscopic management, and, therefore, were included in this study. All patients underwent laparoscopic (low/ultralow) anterior resection with mechanical double-stapled anastomosis. Anastomotic bleeding was successfully managed through a colonoscopy with clips on the first trial in all patients. Hypovolemic shock occurred in one patient, following anastomotic breakdown.
Conclusion
Endoscopic clipping seems to be an effective and safe treatment for anastomotic bleeding with minimal physiologic stress, easy accessibility, and scarce postoperative complications. However, a surgical backup should always be considered for massive bleeding.

Citations

Citations to this article as recorded by

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications
Federica De Muzio, Roberta Fusco, Carmen Cutolo, Giuliana Giacobbe, Federico Bruno, Pierpaolo Palumbo, Ginevra Danti, Giulia Grazzini, Federica Flammia, Alessandra Borgheresi, Andrea Agostini, Francesca Grassi, Andrea Giovagnoni, Vittorio Miele, Antonio B
Journal of Clinical Medicine.2023; 12(4): 1489. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Case Report

Benign GI diease,Rare disease & stoma

McKittrick-Wheelock Syndrome: A Case Series: Maureen Elvira P. Villanueva, Mark Augustine S. Onglao, Mayou Martin T. Tampo, Marc Paul J. Lopez; Ann Coloproctol. 2022;38(3):266-270. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.00745.0106

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187 Download
4 Web of Science
5 Citations

Abstract PDF

McKittrick-Wheelock syndrome is a rare and life-threatening disease characterized by the triad of (1) chronic mucous diarrhea, (2) renal function impairment with hydroelectrolyte imbalance, and (3) a giant colorectal tumor. Often, the tumor is a rectal adenoma. With the mortality being certain, if left untreated, it is important to raise awareness on the presentation, diagnosis, and management of this disease entity. Here, we presented 3 cases of McKittrick-Wheelock syndrome that were successfully managed with surgical resection at the Philippine General Hospital from August 2018 to May 2019. Resolution of their symptoms, reversal of their renal impairment, and correction of their electrolyte depletion were noted after removal of the tumor with a sphincter-saving operation.

Citations

Citations to this article as recorded by

Mckittrick-Wheelock syndrome as a rare manifestation of villous adenoma of the rectum
V.E. Khoronenko, V.S. Trifanov, N.V. Chebotareva, M.Yu. Meshcheryakova, M.V. Kosogolov
Khirurgiya. Zhurnal im. N.I. Pirogova.2024; (3): 76. CrossRef
McKittrick–Wheelock Syndrome: A Case Report
Kristina Marcinkevičiūtė, Marius Kryžauskas, Tomas Poškus
Medicina.2023; 59(3): 633. CrossRef
Rapid Malignant Transformation of Tubulovillous Adenoma, Initially Presenting as McKittrick-Wheelock Syndrome: A Case Report
Ibnu Purwanto, Benedreky Leo, Bambang Purwanto Utomo, Imam Sofii, Ery Kus Dwianingsih, Neneng Ratnasari
Case Reports in Oncology.2023; 16(1): 818. CrossRef
Giant Villous Adenoma of the Rectum With Prolapse: Case Report
Iurii Munteanu, Munteanu Mihaela, Silvia Popescu, Iulian M Slavu, Anca Oprescu Macovei, Daniel Cochior
Cureus.2023;[Epub] CrossRef
Chronic Kidney Disease, Hypokalemia, and Appendicular Mucocele in a 66-Year-Old Man
Sanda Mrabet, Yosr Chaabouni, Mohamed Ben Hmida
American Journal of Men's Health.2022; 16(5): 155798832211255. CrossRef

Technical Notes

Benign GI diease,Surgical technique

Double-layered hand-sewn anastomosis: a valuable resource for the colorectal surgeon: Cristopher Varela, Manar Nassr, Azharuddin Razak, Nam Kyu Kim; Ann Coloproctol. 2022;38(3):271-275. Published online March 17, 2022; DOI: https://doi.org/10.3393/ac.2021.00990.0141

8,076 View
218 Download
2 Web of Science
2 Citations

Abstract PDF Supplementary Material

Hand-sewn anastomosis is an essential and fundamental skill for surgeons dealing with any gastrointestinal anastomosis. Despite the advances in minimally invasive surgery and stapling devices, there are still complex surgical circumstances when the surgeon’s surgical know-how are necessary. Therefore, a safe hand-sewn technique for bowel anastomosis is required to establish a tension-free, well-perfused, and sealed anastomosis that allows gastrointestinal continuity with no unexpected complications. We describe a step-by-step procedure for hand-sewn double-layered anastomosis that reflects these principles and is practical for small and large bowel anastomosis.

Citations

Citations to this article as recorded by

Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Letter to the Editor

Benign GI diease,Minimally invasive surgery,Surgical technique

Learning curve in laparoscopic appendectomy: training strategy of laparoscopic surgery: Hyung Ook Kim; Ann Coloproctol. 2022;38(3):276-277. Published online June 27, 2022; DOI: https://doi.org/10.3393/ac.2020.00010.0001

1,883 View
103 Download

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